Polycystic kidney disease: The Daily PANCE Blueprint

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Polycystic kidney disease: The Daily PANCE Blueprint

A 40-year-old female presents to your clinic with worsening abdominal pain and complains that her urine is turning red. She has a history of chronic UTIs and kidney stones. Her family members also have something similar. On physical exam she has palpable bilateral kidneys. Her labs reveal a decreased globular filtration rate. Which of the following would be the ideal diagnostic test of choice for this patient?

A. Abdominal radiograph
B. Renal biopsy
C. Renal ultrasound
D. MRI of the abdomen/pelvis
E. Exploratory laparotomy

Answer and topic summary

The answer is D. MRI of the abdomen/pelvis

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited cause of kidney disease. It is defined by the development and growth of cysts inside the kidneys. Mutations in 2 genes (PKD1 and PKD2) account for most cases. Clinical features include abdominal pain, recurring UTIs, hematuria, and hypertension. Renal US is the preferred modality of choice for screening patients. However, if the patient has typical findings of ADPKD (it’s highly suspected), it’s recommended to obtain a CT or MRI rather than ultrasound as it can serve as baseline imaging. Management includes blood pressure control, pain management, effective antibiotics for UTIs, and eventual renal replacement therapy (ideally a kidney transplant).

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Renal System ⇒ Congenital or structural renal disorders ⇒ Polycystic kidney disease

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